British Columbia College to review practice of circumcisionIt was not prompted by baby's death, doctor says

A review of the practice of infant circumcision by the College of
Physicians and Surgeons of British Columbia was not prompted by the
surprising death last week of a five-week-old baby shortly after undergoing the procedure, the college spokesman says.

The issue was placed on the agenda of the doctors' regulatory board weeks
ago, prompted by a sternly worded letter issued by Saskatchewan's college,
warning physicians away from performing circumcisions, said Dr. Morris VanAndel, registrar of the B.C. college.

"I guess coincidence would be the term for it," said Dr. VanAndel.

"Added to the mix now is this particular situation. Whether it will
influence the decision, I have no idea."

A five-week-old boy was released from Penticton Regional Hospital after a
circumcision on Aug. 20, but his parents went back to talk to the doctor
later that day with concerns about bleeding.

The situation worsened overnight, forcing them to rush the child back to
hospital early the next day. The infant was flown to B.C. Children's
Hospital in Vancouver. He died two days after the procedure.

The death is under investigation by the coroner's office, said Ian
McKichan, regional coroner. The college is also investigating the
circumstances of the case, said Dr. VanAndel.

An autopsy on the baby was scheduled for yesterday, but the findings were not available. [They are now. They make chilling reading.]

Rates of circumcision vary across Canada, from a high of 27.6% in
Saskatchewan to a low of 0.6% in Newfoundland, according to the
Saskatchewan college.

Dr. VanAndel warned, however, against letting emotion over the incident
interfere with making a sound policy decision.

"Should all decisions be made on an emotional basis because a very tragic and most regrettable complication occurred? Every time somebody dies in a car accident, should we outlaw driving?" said Dr. VanAndel.

[This implies that infant circumcision is as valuable, ethical and victimless as driving. It also implies that Dr. VanAndel has a strongly vested interest in circumcising]

The College of Physicians and Surgeons of Saskatchewan sent a two-page
letter to its members in February, titled Caution Against Routine
Circumcision of Newborn Male Infants.

The letter says: "It is difficult to identify any other domain of medicine
in which physicians would feel comfortable playing such a passive role in
a decision pathway culminating in surgery.

It is also difficult to identify any other domain of medicine in which
practice patterns stand in such stark contrast to research evidence."

A spokesman for a Canadian anti-circumcision lobby group said the death may serve as a wake-up call for parents who treat the decision to
circumcise their babies lightly.

"Infant circumcision is not medically necessary except in the rarest of
situations. It should be remembered that all surgical procedures have
risks, no matter how trivial they may seem at the time," said Arif Bhimji,
a Toronto-area emergency room doctor who is a spokesman for the
Association for Genital Integrity.

A mounting body of medical evidence suggests the procedure is largely
unnecessary and the practice is in decline.

In 1996, the Canadian Pediatric Society published an extensive report in
the Canadian Medical Association Journal that concluded, as an official
stance, that routine circumcision is not recommended.

The Dominion Post (Wellington)Friday August 30, 2002(page 1, top of column 1):

'Quick
snip' an
unkind
cut

CIRCUMCISION is no 'quick snip"
and there is no good medical reason
for babies to have the procedure, four
expert health bodies in New Zealand
have said in a landmark position
statement.

They say circumcision is painful,
risky and often medically unnecessary.

For the fIrst time, the division of
paediatrics and child health of the
Royal Australasian College of Physi-
cians, the Australasian Association of
Paediatric Surgeons, New Zealand Society of Paediatric Surgeons and Urological Society of Australasia have
combined their expert resources and
formulated a joint position statement
on circumcision.

Professor Spencer Beasley, chairman of the circumcision working party, said: "Circumcision is quite a
painful procedure with significant
risks but often the general public
think it's just a quick snip. The college has reviewed evidence in relation to risks and benefits and has concluded there is no evidence of benefit
outweighing harm for circumcision
as a routine procedure."

Professor Beasley said the fashion
for circumcision began in World War
II in North Africa where soldiers often went days without showers and
inflammation of the foreskin from
sand was the most common cause of
absenteeism from the front line.

Silenced for circumcision newsKhartoum - Sudan's state press watchdog has ordered a newspaper closed for
a day as punishment for running an "indecent" article on female
circumcision, despite a government-sponsored campaign against the
practice, sources at the paper said on Tuesday.

The independent al-Ayam daily was ordered to close on Wednesday for
an article which it ran in its women's section the previous week,
about the problems circumcision causes for husbands and wives
during sexual intercourse.

The National Press Council deemed the explicit sexual references
to be "a slur on public decency," the sources said.

Sudanese state-sponsored women's groups and other organisations
are currently running a campaign against female circumcision,
which, although it is banned, is still practised clandestinely by a
significant proportion of the population.

A 1990 Sudan demographic and health survey found that 89%
of women who had been married had undergone some form of genital
cutting, although the figures did not include the war-ravaged south
where the practice is less prevalent.
- Sapa-AFP

Police have been directed to arrest traditional surgeons found forcibly
circumcising men.

Butere-Mumias District Commissioner Ernest Munyi issued the directive
following the forced public circumcision of three elderly men, among them
a senior Mumias Sugar Company employee, in the district.

The administrator said it was wrong for any group to force others into
their traditional practices.

"All people have a right to their tradition and should not be forced into
what they do not want."

Mumias police said they were looking for the people who forcibly
circumcised the three men.

However, a number of traditional circumcisers insisted that they would
continue targeting uncircumcised men during the current circumcision
season in most parts of western Kenya, saying their tradition demanded
that all men be circumcised.

Meanwhile, a man who was forcibly circumcised at Mayoni trading centre and later dumped bleeding by the roadside has instructed a lawyer to take up
the matter and sue his attackers.

Tyamara insisted this week that his lifestyle did not allow for the
tradition which entails young men being circumcised and remaining in
isolation with other initiates for some three weeks, at the end of which
they are considered to be men.

He said was too busy earning a living to take time out for the ceremony.
He also feared for his health and safety at an initiation school. He
insisted that he did practise other Xhosa traditions. "I do not disrespect
my culture."

Baloyi, Bafana Bafana and Kaizer Chiefs goalkeeper, said he sympathised with Tyamara. He revealed that he did not undergo circumcision as required in Shangaan tradition because of soccer commitments. He was already playing for the Kaizer Chiefs junior side as a teenager.

"Honestly, I never had time to go to the bush although lots of my friends
in Alexandra went. But I had to make a choice between that and soccer. I
chose soccer," he said.

"I feel that people have to face reality and acknowledge that some things
can't be done like our elders did in the past, because of today's living
conditions," he said.

Metro FM and club DJ Lewis said: "I know my father had a problem with me not going to the bush, but it went away. People are dying in the bush
anyway."

Retired boxing champion Baby Jake Matlala said he had also not undergone
the tradition as required in Pedi custom, but had opted for a quicker
solution by going to hospital.

"I support circumcision when it's done in the hospital. The dangers that
go with initiation schools have really turned us against the idea," he
said.

Award-winning jazz musician and producer Selota said he too had not
undergone the circumcision ceremony.

"What's the use of going to the mountain and claiming to practise a
culture that is already eroded? The world has become Westernised and there
is no platform to practise what you have been taught at the initiation
school," he said.

Tyamara has also gathered some heavyweight detractors.

Dr Mathole Motshekga, former Gauteng premier and now head of the Kara Heritage Institute, which specialises in African culture, said there was
no basis for Tyamara to refuse to undergo the tradition.

"There are basic rules of life that have to be followed and deviating from
them leads to serious problems like moral degeneration.

"Our children don't go to circumcision schools, they watch American films, and that's why we have so much moral degeneration. Initiation cannot be rejected in the name of modernity," he said.

Chief Phathekile Holomisa, chairman of the organisation of traditional
leaders, Contralesa, said: "It's his democratic right not to go, but he
will always be considered a boy, even when he is old and grey. He will
scandalise any woman he will marry because a woman cannot marry a boy," he said.

"Lundi is not a man to me, he is an inkwenkwe (young boy)," said Yfm DJ and Celebrity Big Brother housemate Thomas "Bad Boy T" Msengana, who underwent the ceremony when he was 20 in Langa township outside Cape Town.

"This is one thing we cannot afford to let go. If this dies, what else
would we have?"

SABC1 continuity presenter Brian Ndevu warned Tyamara that he would have problems in future if he refused to honour the obligation.

"That could have serious consequences. This is a rite of passage to
manhood for every Xhosa man," he said, adding: "By not going there you can
never enter the circles of Xhosa men."

Sen. Jery O'Neil, R-Kalispell, had hoped to pitch his Senate Bill 24
before the Senate Taxation committee Thursday morning, which would
make low income Montanans receiving Medicaid pay for their own circumcisions or, perhaps, not get them altogether. [Not "their own" of course. This error underlines the confusion about circumcision.]

"It's harmful to babies, it's traumatic," said O'Neil, referring to
the process by which a doctor surgically removes the foreskin from a
young male infant's penis. "It doesn't improve life function," and in some
cases can actually be harmful."

DOUBLE standards allowed two boys to be circumcised without their
mother's permission, an outraged Australian Health group said yesterday.

Circumcision Information Australia spokesman Shane Peterson said the
case in which a six- and nine-year-old boy were circumcised by their
Bundaberg father, despite their mother's opposition, was "a tragedy''.

"In European countries the written permission of both parents is
necessary before a doctor can legally perform a circumcision on boys,'' Mr
Peterson said.

"This rule should be implemented in Australia to prevent such
tragedies.''

Mr Peterson said the case illustrated a double standard whereby female
circumcision was condemned as mutilation while male circumcision was
viewed as trivial or even a beneficial adjustment.

He said the case also highlighted the lack of implementation of the UN
Convention on the Rights of the Child by Australian law.

The mother of the boys is also angry at what she sees as a double
standard on circumcision.

"If I had been in this current situation with two daughters who were
circumcised by their Muslim father, the Australian public would be
outraged,'' said the woman, who cannot be identified for legal reasons.

"Because it is my two sons who have been harmed, few people seem to
care.''

She said her estranged husband had performed the operation during an
access visit to the children last year.

Grievous bodily harm and unlawful wounding charges were laid against the boys' father, but these were dropped on Thursday when the prosecution
revealed they were not ready to proceed with their case.

Detective Senior Constable Peter Cormack, from the Gold Coast child
abuse
investigation unit, said police would still pursue the case, on which
charges could still be laid.

Berkeley, CA (July 29, 2002)
North Dakota District Judge
Cynthia Rothe-Seeger has denied a motion for summary judgment by defendants in the Flatt v. Kantak circumcision case. It will proceed to
trial on February 3, 2003. The precedent-setting decision confirms that a
baby who is circumcised can sue his doctor when he reaches the age of
majority, even if there was parental consent for the circumcision, and
even if the results are considered to be 'normal.'

"This is the latest in a series of warnings to doctors who still circumcise: proceed at your peril, because even if you get parental consent and do a standard job of the circumcision, the child can still grow up and sue you for taking away part of his penis," says lawyer J. Steven Svoboda, executive director of Attorneys for the Rights of the Child (ARC).

Like the case of William Stowell proceeding in New York, this case would be a breakthrough in establishing that circumcision is litigious even where there is no "botch" and "consent" is given, but there are problems with the "consent." In this case, the mother was not informed about the procedure prior to signing the "consent" form.

Plaintiff Flatt's attorney Zenas Baer says, "There will be a nine-person jury hearing this precedent-setting case. I am optimistic we will be able to have the 'informed consent' issue decided by the jury."

Svoboda said, "This is the second significant legal victory this year,
after the case of William Stowell also survived summary judgment and is
proceeding to trial. Both cases will establish that, even where the
procedure is performed at the professional standard, a circumcision is
litigious if the consent is not informed."

Baer added, "The court also observed that, in an informed consent case,
the type of information to be disclosed to a parent is a 'standard set by
law for physicians rather than one which physicians may or may not impose
upon themselves.' This is a huge statement and will put the physicians in
their place if we can convince nine reasonable people that the physicians
failed to give adequate information."

Marilyn Milos, Director of NOCIRC, an organization that seeks to end routine infant circumcision in North America, says, "Female genital mutilation has been outlawed, and we need the law to set the standard here, too, followed by aggressive educational programs. Parents and doctors need to know that this is a harm that lasts a lifetime."

Svoboda stated "The foundation is well laid for lawsuits. Doctors who are
still doing circumcisions are already investing in a lot of trouble, and
this case will make their troubles worse. They just have to wait 18 years
until that baby grows up, and they're in for a lawsuit. An army of lawyers
will be there with this precedent and many more in their arsenal."

This landmark case brings into question whether a physician can remove
healthy, normal tissue from unconsenting minors for non-therapeutic
reasons, and whether a parent can legally consent to a medically
non-indicated surgery for a minor child. Svoboda is convinced that this
case will have a major impact on circumcision in the U.S. "Doctors ignore
a lot of medical literature," he said, "and they ignore the screams of the
babies, but they listen when they hear the word 'malpractice.' As a lawyer
willing to sue, I've never had a doctor not listen to me."

Arizona and Missouri have recently dropped Medicaid funding for
circumcision, joining six states, and other states are considering similar steps. The American Academy of Pediatrics (AAP) first acknowledged that there was no medical justification for routine circumcision in 1971. In 1999, the AAP reaffirmed that it does not recommend routine circumcision. The American Medical Association concurred in 2000, calling routine circumcision "non-therapeutic." No national or international medical organization recommends routine circumcision. The United States is the only country that continues to circumcise the majority of its newborns for
non-religious reasons. As parents have become more educated about the
surgery, the circumcision rate in the US has fallen to 57%.

The state budget that will begin July 1, 2002, includes several cost-containment
measures in the Medicaid program. These changes affect both Medicaid fee-for-service
and MC+ managed care recipients. These changes include, but are not limited
to the following:

...Coverage for male circumcisions will be eliminated
except for medical necessity.

This brings the number of US states that no longer fund circumcision through Medicaid to eight.

UN Human Rights Commission accepts circumcision paper

English only

COMMISSION ON HUMAN RIGHTS
Sub-Commission on the Promotion
and Protection of Human Rights
Fifty-fourth session
Item 6 (c) of the provisional agenda

OTHER HUMAN RIGHTS ISSUES:
OTHER ISSUES

Written statement* submitted by the National Organization of Circumcision Information
Resource Centers (NOCIRC), a non-governmental organization on the Roster

The Secretary-General has received the following written statement which is circulated in accordance with Economic and Social Council resolution 1996/31.

16. NOCIRC asks that the mandate of the Special Rapporteur on Traditional Practices Affecting the Health of Women and the Girl Child be revised to again encompass traditional practices affecting the health of women and children.

17. NOCIRC asks that the Sub-Commission undertake a study of male circumcision as a human rights violation.

The East African
Saturday Nation on the Web
Friday July 05, 2002
WEEKEND MAGAZINE HOME

How govt foots the FGM bill

By NATION Reporter
Just four months after Kenya made it illegal to circumcise girls, one can
still take a daughter or sister for the operation and earn Sh1,000 from
the government for it.

Female Genital Mutilation has moved from traditional circumcisers to the
clean and sterile minor theatres in recognised Kisii hospitals, performed
by trained nurses. ...

Badly kept secret

Circumcision of girls in the hospitals of Kisii District is not a secret.
A parent or guardian who wants a daughter circumcised will only need to
inform the nurses in charge – and it is over and done within minutes. ...

Campaigners against female genital mutilation have been arguing that the
danger of HIV/Aids infection posed by circumcising girls using
unsterilised equipment made the practice dangerous. Now, with qualified
health professionals carrying out the operation in homes and hospitals,
that argument is becoming null and void. It also takes the fight back to
Square One. ...

The nurses who organise with parents to circumcise their daughters
privately in homes are happy for the extra income.

"It is the culture of the people and if that is what they want done to
their daughters, we grant it," argues a nurse. Although she says she will
not have her daughters circumcised, she sees nothing really wrong with the
practice.

"It's a minor incision and after they are bandaged, they quickly heal. In fact, a few hours after the operation, you see the girls jumping up and down," she confides. ...

At the Kisii District General Hospital, circumcision of girls is carried
out under the pretext of admitting them for malarial or other treatment. ...

Hema Hospital response: "Circumcision of girls in the hospital? Never.
Boys we do, but girls never! In fact the sister-in- charge, who is my
wife, gives lectures everywhere condemning circumcision of girls. And if
you write that we do it here you must come with tangible evidence, we will
take you to court!" says the owner Dr Hezron Manduku.

The full text of the article focuses on the insurance-fraud aspect. If it has been taken down, email me and it will be posted here.

Polokwane - Altogether 630 initiates, including some as young as eight,
have been rescued from bogus initiation schools in Limpopo in the past
week and taken to various hospitals.

MEC in the office of Premier Ngoako Ramatlhodi, Catherine Mabuza, accompanied emergency ambulance services and police in armoured vehicles on Tuesday and closed down six more schools in the Waterberg district in the Mokopane area.

The clampdown on initiation schools follows the death of 19-year-old Mazka Kgatla who bled to death after being circumcised at Mokgolobotho village initiation school near Tzaneen last week....